ID

29073

Beschrijving

Study ID: 101468/249 Clinical Study ID: 101468/249 Study Title: A 12-Week, Double-Blind, Placebo Controlled, Parallel Group Study to Assess the Efficacy and Safety of Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: NCT00363857 Sponsor: GlaxoSmithKline Collaborators: N/A Phase: N/A Study Recruitment Status: Completed Generic Name: ropinirole Trade Name: Modutab,ZIPEREVE,ZEPREVE,REPREVE,ADARTREL,REQUIP,Zygara; Zygara,ZIPEREVE,ZEPREVE,Requip Depot,REQUIP,REPREVE,Modutab,ADARTREL Study Indication: Restless Legs Syndrome; Restless Legs Syndrome (RLS)

Trefwoorden

Versies (1)
  1. 23-02-18 23-02-18 -
Houder van rechten

GlaxoSmithKline (GSK)

Geüploaded op

23 februari 2018

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0
Model Commentaren :

Hier kunt u commentaar leveren op het model. U kunt de tekstballonnen bij de itemgroepen en items gebruiken om er specifiek commentaar op te geven.

Terug naar het model Commentaren
Itemgroep Commentaren voor :

Item Commentaren voor :

U moet ingelogd zijn om formulieren te downloaden. AUB inloggen of schrijf u gratis in.

Clinical Study, Ropinirole in Patients Suffering from Restless Legs Syndrome (RLS), Study ID: 101468/249, NCT00363857

Engels

Abnormal findings at the Screening Visit

1 Formulieren  
Administration
Beschrijving

Administration

Alias
UMLS CUI-1
C1320722
Patient number
Beschrijving

Patient number

Datatype

integer

Alias
UMLS CUI [1]
C1830427
Visit date
Beschrijving

Visit date

Datatype

date

Alias
UMLS CUI [1]
C1320303
Center Number
Beschrijving

Center Number

Datatype

integer

Alias
UMLS CUI [1,1]
C1301943
UMLS CUI [1,2]
C0600091
Electrocardiogram (12 lead)
Beschrijving

Electrocardiogram (12 lead)

Alias
UMLS CUI-1
C0430456
Date of ECG
Beschrijving

Dato of ECG

Datatype

date

Alias
UMLS CUI [1]
C2826640
Were any clinically significant abnormalities detected?
Beschrijving

If ’Yes’, please record details in the Baseline Signs and Symptoms and/or SAE section at the back of this book and exclude the patient from the study.

Datatype

integer

Alias
UMLS CUI [1]
C0522055
Laboratory evaluation
Beschrijving

Laboratory evaluation

Alias
UMLS CUI-1
C0022885
Date of sample
Beschrijving

Date of sample

Datatype

date

Alias
UMLS CUI [1]
C1302413
Were any clinically significant abnormalities detected?
Beschrijving

If ‘Yes’, please record the findings and/or diagnosis in the Baseline Signs and Symptoms and/or SAE section at the back of this book and exclude the patient from the study.

Datatype

integer

Alias
UMLS CUI [1]
C1853129
Terug naar het begin van de pagina

Similar models

Abnormal findings at the Screening Visit

1 Formulieren
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Administration
C1320722 (UMLS CUI-1)
Patient number
Item
Patient number
integer
C1830427 (UMLS CUI [1])
Visit date
Item
Visit date
date
C1320303 (UMLS CUI [1])
Center Number
Item
Center Number
integer
C1301943 (UMLS CUI [1,1])
C0600091 (UMLS CUI [1,2])
Item Group
Electrocardiogram (12 lead)
C0430456 (UMLS CUI-1)
Dato of ECG
Item
Date of ECG
date
C2826640 (UMLS CUI [1])
Item
Were any clinically significant abnormalities detected?
integer
C0522055 (UMLS CUI [1])
ECG abnormalities
Code List
Were any clinically significant abnormalities detected?
CL Item
No (1)
CL Item
Yes (2)
Item Group
Laboratory evaluation
C0022885 (UMLS CUI-1)
Date of sample
Item
Date of sample
date
C1302413 (UMLS CUI [1])
Item
Were any clinically significant abnormalities detected?
integer
C1853129 (UMLS CUI [1])
Laboratory abnormalities
Code List
Were any clinically significant abnormalities detected?
CL Item
No (1)
CL Item
Yes (2)
Terug naar het begin van de pagina 

Contact

Gebruik dit formulier voor feedback, vragen en verbeteringsvoorstellen.

Velden gemarkeerd met een * zijn verplicht.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial